Evaluation of BRAF V600E mutation status combined with cytomorphological features for diagnosis of PTC in cytologically indeterminate thyroid nodules can significantly improve diagnostic accuracy and reduce the number of diagnostic operations (calculator available at www.ptc-calc.we2host.lt).

No abstract

Introduction Bile duct injuries (BDIs) still occur during laparoscopic cholecystectomy. Although management of such complications is challenging, collaboration of a multidisciplinary team and development of treatment methods and materials often lead to the successful treatment. Materials and methods Medical records of 67 patients who have experienced bile duct injures after laparoscopic cholecystectomy were retrospectively reviewed. All injures were classified according to the European Association for Endoscopic Surgery ATOM classification and investigated by manifestation of the injury, surgical repair technique, early and late complications. Results In 28 (41.8 %) patients with partial divisions, the surgical treatment of BDI was completed with endoscopic retrograde cholangiopancreatography (ERCP) and stenting while in 14 (20.1%) cases, the defect of bile duct was closed by suture. End-to-end ductal anastomosis was performed for 6 (13.4%) patients with complete division while 19 (28.3%) patients underwent hepaticojejunostomy. We followed up 58 (92.1%) of 63 patients. The mean follow-up duration was 25.7 (3 - 123) months. Twenty-three (39.7%) patients were found with strictures. Discussion Intraoperative detection and management of BDIs is crucial to achieve good results. The routine intraoperative cholangiography and possibilities of repair by initial surgeons in peripheral hospitals remain controversial. Stenting with a covered self-expanding metal stent is promising for the patients with partial divisions of bile ducts. Initial hepaticojejunostomy is often a preferred treatment for transected bile ducts because of lower rate of anastomosis strictures. However, as end-to-end anastomosis is more physiological, and endoscopy allows successful management of the strictures, we suggest choosing this treatment when possible Recommendation for paperwork content: Classifying bile duct injuries according to the new ATOM classification may be useful in the decision of the most appropriate treatment in each case.

Dvylikapirštės žarnos divertikulai yra dažniausia divertikuliozės vieta plonojoje žarnoje. Nuo 1 % iki 5 % tokių divertikulų yra simptominiai ir pasireiškia skausmu, kraujavimu, uždegimu, cholestaze, cholangitu, obstrukcija, perforacija, pankreatitu ar piktybine transformacija. Pati sudėtingiausia komplikacija yra perforacija, kuri sudaro 0,03 %. Diagnozavus dvylikapirštės žarnos divertikulo perforaciją, tradicinis gydymas buvo paprasta divertikulektomija ir dvylikapirštės žarnos užsiuvimas dviem sluoksniais su retroperitoninio tarpo drenavimu. Pastaruoju metu aprašoma vis daugiau sėkmingų konservatyvaus ir kitokio chirurginio gydymo atvejų. Mes aprašome savo patirtį, susijusią su dvylikapirštės žarnos divertikulito gydymu atliekant Roux-en-Y duodenojejunostomiją Shigeru Fujisaki metodu po nesėkmingo konservatyvaus gydymo.

No abstract